This revised proposal is designed in response to the federal government's initiative to increase national organ donation rates. It is well documented that the need for donor organs far exceeds the rate at which viable organs are donated, and that increasing donation rates is the most critical issue facing the field of clinical transplantation. To date, research efforts have focused mostly on enhancing public attitudes and willingness to become organ donors with comparably less scientific effort to identify those factors that are most predictive of actual next-of-kin donation consent. Since organ donation depends almost exclusively on the consent of family members it is imperative that we enhance our understanding of those variables that are likely to lead to favorable consent decisions. Using a conceptual model developed by Radecki and Jaccard, we will examine the associations of next-of-kin beliefs and attitudes and knowledge of the deceased's donation intentions to organ donation decisions. Variables hypothesized to be associated with donation decisions based on the extant literature include: next-of-kin belief structure, attitude toward organ donation, and coping resources. Approximately 250 next-of-kin to whom a donation request was targeted will be interviewed by telephone within two weeks of the request and assessed on several variables guided by the conceptual model. Hierarchical logistic regression will be used in the data analysis. It is expected that results from this study will enhance our understanding of the most salient individual and contextual factors that affect organ donation consent and guide the development of effective request strategies.